Characteristics of Patients Who Avoid Wheat and/or Gluten in the Absence of Celiac Disease

被引:48
作者
Tavakkoli, Anna [1 ]
Lewis, Suzanne K. [1 ]
Tennyson, Christina A. [1 ]
Lebwohl, Benjamin [1 ,2 ]
Green, Peter H. R. [1 ]
机构
[1] Columbia Univ, Dept Med, Celiac Dis Ctr, New York, NY 10032 USA
[2] Columbia Univ, Dept Epidemiol, Mailman Sch Publ Hlth, New York, NY 10032 USA
关键词
Patients who avoid wheat and/or gluten; Celiac disease; Gluten-free diet; Alternative diagnoses; IRRITABLE-BOWEL-SYNDROME; FREE-DIET; CONTROLLED-TRIAL; BLOOD-PRESSURE; GRAIN FOODS; SENSITIVITY; PREVALENCE; DIARRHEA; HEALTH; FIBER;
D O I
10.1007/s10620-013-2981-6
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Gastrointestinal symptoms that respond to the removal of wheat and/or gluten are becoming more common. Patients who avoid wheat and/or gluten (PWAWG) are a heterogeneous group and predominantly self-diagnosed prior to presenting for clinical evaluation. We characterized PWAWGs seen at a tertiary care referral center and compared them to patients with celiac disease (CD) and subjects in the National Health and Nutrition examination survey (NHANES). This was a cross-sectional study evaluating patients seen by four gastroenterologists at a CD referral center. Baseline characteristics, laboratory values, and medical comorbidities were compared to CD patients who presented at the same center and subjects enrolled in NHANES. Eighty-four PWAWGs were identified and compared to 585 CD patients and 2,686 NHANES patients. Thirty-two alternative diagnoses were made in 25 (30 %) PWAWGs, including small intestinal bacterial overgrowth and fructose/lactose intolerance. When compared to patients with CD, PWAWGs had similar body mass index (BMI, 23.1 vs. 23.5, p = 0.54) and mean hemoglobin value (13.4 vs. 13.3, p = 0.6). When compared to male and female patients in NHANES, BMI, folate, and mean hemoglobin values were lower in PWAWGs. Both male and female PWAWGs had a lower prevalence of hypertension. While there are similarities between CD and PWAWGs that could possibly be due to shared HLA haplotypes or an effect of the gluten-free diet, alternative diagnoses are common in these patients. PWAWGs have a similar cardiovascular profile as CD patients in terms of lower BMI and lower prevalence of hypertension.
引用
收藏
页码:1255 / 1261
页数:7
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